WO2014157729A1 - Système de fourniture d'informations et procédé de commande de système de fourniture d'informations - Google Patents

Système de fourniture d'informations et procédé de commande de système de fourniture d'informations Download PDF

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Publication number
WO2014157729A1
WO2014157729A1 PCT/JP2014/059581 JP2014059581W WO2014157729A1 WO 2014157729 A1 WO2014157729 A1 WO 2014157729A1 JP 2014059581 W JP2014059581 W JP 2014059581W WO 2014157729 A1 WO2014157729 A1 WO 2014157729A1
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Prior art keywords
information
medical
consenter
facility
patient
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PCT/JP2014/059581
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English (en)
Japanese (ja)
Inventor
至孝 川上
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三菱化学メディエンス株式会社
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Priority to JP2015508831A priority Critical patent/JPWO2014157729A1/ja
Publication of WO2014157729A1 publication Critical patent/WO2014157729A1/fr

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    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/40—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for data related to laboratory analysis, e.g. patient specimen analysis

Definitions

  • the present invention relates to an information providing system for medical information and a control method for the information providing system.
  • the medical facilities belonging to a specific medical area will advance the function sharing and specialization according to the situation of the local medical care regarding the features such as their functions and scale, and patients will provide appropriate medical services with continuity. It is intended to be received.
  • Regional medical cooperation is expected to be effective not only in medical facilities but also in cooperation between medical facilities and other medical-related service providing facilities such as clinical laboratory facilities and dispensing pharmacies.
  • the medical-related service is a clinical laboratory as an example, most clinical laboratories are currently performed in core hospitals and large clinical laboratories in the region.
  • An embodiment in which a clinical test is performed at a core hospital upon receiving a request from a clinic where a patient has consulted, or a clinical test is performed at a clinical laboratory in response to a request from a clinic or core hospital are various.
  • Management of medical information is being considered as one of the tools to achieve regional medical cooperation, but this involves sharing medical information in each regional medical area using information integration technology of IT (Information Technology). A common information infrastructure is required.
  • IT Information Technology
  • a medical facility and a terminal are connected via a network, and information related to medical practice is transmitted from the management system in the medical facility to the terminal via the network (Patent Document 1).
  • a medical information management system (Patent Document 2) that centrally manages medical information in a medical information system of a plurality of medical facilities via a network, and a medical information management system (Patent Document 3) provided with personal information protection means. Proposed.
  • test system disclosed in Patent Document 1 is such that when a patient undergoes a clinical test at a contracted clinical laboratory other than the main clinical laboratory, the clinical test result is a contracted clinical test other than the main clinical laboratory. It is transferred from the clinical testing terminal of the facility to the clinical testing terminal of the main clinical laboratory. Furthermore, the clinical test result is notified to the doctor terminal in the medical facility and transferred to the electronic medical record system. That is, it does not consider the case where a patient's clinical examination is performed by a plurality of clinical examination facilities.
  • Patent Document 2 discloses a medical information management system that centrally manages medical information via a network and includes personal information protection means.
  • the access right to the database is limited to the medical facility in which the medical information is registered, and there is a possibility that even the medical information of the disagreement patient is included in the database.
  • facilities newly participating in regional medical cooperation have no access authority, and the purpose of sharing medical information among many medical facilities cannot be achieved.
  • Patent Document 3 describes a medical information management system that centrally manages medical information in medical information systems of a plurality of medical facilities via a network.
  • the medical information management system patient information that each of a plurality of medical facilities individually has is integrated and managed, access to a database is restricted, and medical information is provided based on personal authentication.
  • there is a risk of personal information leakage because personal information and medical information are not separated, and information on patients who disagree with disclosure of personal information is not discarded. I can't throw it away.
  • the medical facility directly registers information in the medical information management system, it is not assumed that the clinical test results performed in a plurality of clinical laboratory facilities are managed in an integrated manner. Therefore, even in such a medical information management system, it must be said that the amount of shared medical information is insufficient, and it is not possible to provide a highly convenient service.
  • the technology disclosed in the present disclosure has been made in view of the above circumstances, and the purpose thereof is to provide a variety of medical information created by a plurality of medical facilities providing medical-related services while protecting personal information. Is to realize a system that can be provided to a plurality of medical facilities in a simple format.
  • An information providing system includes a consenter information storage unit that stores consenter information in which medical facility information and patient identification information are associated and extracted from an information storage device accessible by a terminal of a medical facility
  • a medical information storage unit accessible by a terminal of a medical service providing facility requested by a medical facility, wherein medical facility information, patient identification information, and requested medical service information
  • Consent person information extraction which extracts medical person information which has medical facility information memorized in medical information storage part from medical information memory part which memorizes linked medical information, and consenter information memorized in consenter information memory part Part, the consenter information specifying part for specifying the medical information having the patient identification information of the extracted consenter information among the medical information, and the specified medical information are transmitted to the information storage device And a care information transmitting unit.
  • medical information such as clinical test results provided by the medical-related service providing facility among a plurality of medical facilities.
  • the consenter information stored in the consenter information storage unit is such that items that the patient does not agree are associated with the medical facility information and the patient identification information.
  • a non-consent item deletion unit that deletes items that the patient does not agree with included in the extracted consenter information.
  • the information provision system by one Embodiment is further provided with the medical information deletion part which deletes medical information other than the specified medical information among medical information.
  • the information providing system further includes a format conversion unit that converts the format of the specified medical information, and the medical information transmission unit transmits the medical information whose format has been converted.
  • the information provision system by one Embodiment is further provided with the master conversion part which converts the master of the specified said medical information, and a medical information transmission part transmits the medical information which converted the master.
  • medical information includes any of medical record information, receipt information, medical information, preventive health information, welfare information, and information related to biological samples of Biobank.
  • the medical information is medical chart information, and the medical chart information includes any of clinical test results, doctor's findings, progress and results of treatment, nursing records, prescriptions, and outpatient histories.
  • the control method of the information providing system includes the consenter information obtained by associating the medical facility information and the patient identification information extracted from the information storage device accessible by the medical facility terminal.
  • the medical information storage unit stores the medical facility information, the identification information of the patient, and the requested medical related service in the medical information storage unit that is stored in the information storage unit and accessible by the terminal of the medical related service providing facility requested by the medical facility.
  • the medical information associated with the information is stored, and from the consenter information stored in the consenter information storage unit, the consenter information having the medical facility information stored in the medical information storage unit is extracted, and among the medical information, Medical information having patient identification information corresponding to the extracted consenter information is specified, and the specified medical information is transmitted to the information storage device.
  • the consenter information stored in the consenter information storage unit is such that items that the patient does not agree are associated with the medical facility information and the patient identification information. Items that the patient does not consent to are included in the extracted consenter information is deleted from the medical information. Furthermore, the control method of the information provision system by one Embodiment deletes medical information other than the specified medical information among medical information.
  • control method of the information provision system by one Embodiment converts the format of the specified medical information, and transmits the medical information which converted the format.
  • the information providing system control method according to the embodiment converts the specified medical information master, and transmits the medical information converted from the master.
  • medical information includes any of medical record information, receipt information, medical information, preventive health information, welfare information, and information related to biological samples of Biobank.
  • the medical information is medical chart information, and the medical chart information includes any of clinical test results, doctor's findings, progress and results of treatment, nursing records, prescriptions, and outpatient histories.
  • the medical facility information extracted from the information storage device accessible by the terminal of the medical facility is associated with identification information of an individual including at least a patient or a medical information provider.
  • the consenter information storage unit for storing the consenter information and the medical information storage unit accessible by the terminal of the medical service providing facility for which the medical service is requested from the medical facility, and identifying the medical facility information and the individual Medical facility information stored in the medical information storage unit from the medical information storage unit that stores the medical information in which the information and the requested medical-related service information are associated, and the consenter information stored in the consenter information storage unit
  • the consenter information extraction unit for extracting the consenter information having the information, and the consenter information specification for identifying the medical information having the personal identification information of the extracted consenter information among the medical information When, and a medical information transmitting unit for transmitting the identified medical information in the information storage device.
  • a method for controlling an information providing system wherein medical facility information extracted from an information storage device accessible by a medical facility terminal is associated with identification information of an individual including at least a patient or a medical information provider.
  • the attached consenter information is stored in the consenter information storage unit, and the medical facility information and the individual identification are stored in the medical information storage unit accessible by the terminal of the medical service providing facility requested by the medical facility.
  • Information about the medical facility in which the information related to the requested medical-related service is stored, and the consenter information having the medical facility information stored in the medical information storage unit from the consenter information stored in the consenter information storage unit The medical information having personal identification information corresponding to the extracted consenter information is specified from the medical information, and the specified medical information is transmitted to the information storage device.
  • the information providing system and the control of the information providing system that can share medical information created by a plurality of medical facilities that provide medical related services while protecting personal information among the plurality of medical facilities.
  • a method is realized.
  • FIG. 1 is a diagram illustrating a schematic configuration of regional medical cooperation having an information providing system according to an embodiment.
  • FIG. 2 is a diagram illustrating a schematic hardware configuration of an information providing system according to an embodiment.
  • FIG. 3 is a diagram illustrating the contents of personal information and consenter information stored in the regional medical cooperation server in a tabular format according to an embodiment.
  • FIG. 4 is a diagram illustrating an example of items of the consenter information stored in the consenter information DB according to the embodiment.
  • FIG. 5 is a diagram illustrating an example of items of clinical test results stored in the clinical test result information DB for the clinical test center in one embodiment.
  • FIG. 6 is a diagram illustrating a flowchart of processing executed by the information providing system in one embodiment.
  • FIG. 1 is a diagram illustrating a schematic configuration of regional medical cooperation having an information providing system according to an embodiment.
  • FIG. 2 is a diagram illustrating a schematic hardware configuration of an information providing system according to an embodiment.
  • FIG. 3 is a diagram
  • FIG. 7 is a diagram illustrating a flowchart of processing executed by the information providing system in one embodiment.
  • FIG. 8 is a diagram illustrating a flowchart of processing executed by the information providing system in one embodiment.
  • FIG. 9 is a diagram illustrating a flowchart of processing executed by the information providing system in one embodiment.
  • FIG. 10 is a diagram illustrating a flowchart of processing executed by the information providing system in one embodiment.
  • FIG. 11 is a diagram illustrating a flowchart of processing executed by the information providing system and the regional medical cooperation server in the embodiment.
  • FIG. 12 is a diagram illustrating a flowchart of processing executed by the information providing system in another embodiment.
  • FIG. 13 is a diagram illustrating a flowchart of processing executed by the information providing system in another embodiment.
  • FIG. 14 is a diagram illustrating a schematic hardware configuration of an information providing system according to another embodiment.
  • medical service refers to the act of conducting diagnosis and treatment by a doctor.
  • Medical facilities mainly mean facilities that provide medical services, and include clinics and hospitals.
  • Medical-related services are services related to medical services other than medical services, and may be any services that are listed in the Enforcement Regulations of the Medical Law, such as contract clinical testing, dispensing pharmacy services, and sales / maintenance inspection of medical devices.
  • the medical-related service providing facility refers to a facility that provides a medical-related service, and includes, for example, a clinical laboratory and a clinical laboratory center. In some medical facilities such as hospitals, there are cases where clinical testing facilities, for example, medical related service providing facilities such as clinical testing centers and shared use facilities exist.
  • medical information includes medical record information, receipt information, and medical examination information.
  • the medical record information includes clinical test results, doctor's findings, progress and results of treatment, nursing records, and the like.
  • medical information includes medical facility information provided by medical facilities, medical information that describes the merits and demerits in addition to the methods of clinical examinations, diagnosis, and treatment, vaccinations, and prevalence of infectious diseases.
  • Welfare information about aftercare other than treatment such as prevention information and health information such as prevention of food poisoning, home care and care information after discharge, economic and psychological support, etc.
  • medical information such as the above-described clinical test results, prescriptions, medical chart contents, and hospital history can be easily shared between a plurality of medical facilities without risk of personal information leakage.
  • the personal information is information that can identify a specific individual and includes, for example, information defined by a law relating to the protection of personal information.
  • information that can identify the individual by combining a plurality of pieces of information is also included in the personal information.
  • Examples include biometric information, computer IP addresses, and information on remote hosts. Biometric information such as fingerprints, vein patterns, irises, and DNA base sequences may be handled as personal information, but in the present embodiment, these are information included in medical information.
  • regional medical cooperation refers to sharing medical information associated with medical services and medical-related services provided for patients using a plurality of different medical facilities, for example, designated by the Ministry of Health, Labor and Welfare. This includes providing medical services and medical-related services by linking medical facilities in the primary to tertiary medical areas and medical-related service providing facilities.
  • the consenter refers to a patient who has received a sufficient explanation about the policy of the service to receive when receiving a medical service or a medical-related service, and that correctly understands, agrees with, and agrees with.
  • the content of the consenter's consent varies depending on the type of consent to be obtained. For example, consent to participate in regional medical cooperation in the medical area to which the medical facility providing the service belongs, consent to share medical information in multiple medical facilities, secondary medical information in a form where personal information is separated Consent to use (such as cohort studies) is included.
  • the type of consent is appropriately selected according to the use form of the service by the patient. For example, individual patients can agree on all or some of the contents of the shared medical information. For example, the patient appropriately selects the content of consent according to the form of provision of medical service or medical related service, such as agreeing to share only specific items of medical record information, medication history, clinical test results among medical information can do.
  • the consenter information includes a number assigned to each medical facility, a number assigned to each patient by each medical facility, and the numbers of primary to tertiary medical areas to which the medical facility belongs as necessary. Can be added.
  • the contents of the agreed medical information can be added with a number. In particular, in the case of a patient who agrees only on some items, information on items of medical information that have been agreed can be added.
  • FIG. 1 is a diagram showing a schematic configuration of regional medical cooperation having an information providing system 10 in the present embodiment.
  • the information providing system 10 is connected to a server (not shown) of a hospital A100 or hospital B200 via a network N such as a LAN (Local Area Network) or the Internet.
  • the server manages and processes personal information and medical information related to patients who receive medical services at each hospital.
  • the information providing system 10 is also connected to the regional medical cooperation servers 300 and 400 via the network N. Further, the information providing system 10 is connected to a clinical laboratory center A 500, a clinical laboratory center B 600, and a clinical laboratory center C 700 through a network (not shown).
  • FIG. 1 is a diagram showing a schematic configuration of regional medical cooperation having an information providing system 10 in the present embodiment.
  • the information providing system 10 is connected to a server (not shown) of a hospital A100 or hospital B200 via a network N such as a LAN (Local Area Network) or the Internet.
  • the server manages and processes personal information
  • Hospital A100 and hospital B200 correspond to examples of medical facilities.
  • the clinical laboratory center A500, clinical laboratory center B600, and clinical laboratory center C700 correspond to an example of a medical-related service providing facility.
  • the regional medical cooperation servers 300 and 400 correspond to an example of an information storage device that can be accessed by a terminal of a medical facility.
  • Each terminal in the hospital A100, the hospital B200, the clinical laboratory center A500, the clinical laboratory center B600, and the clinical laboratory center C700 performs the following processing.
  • the hospital A100, the hospital B200, and the clinical laboratory center A500 The clinical laboratory center B600 and the clinical laboratory center C700 will be described and illustrated on behalf of them.
  • a relay server may be installed as a security measure against viruses.
  • FIG. 2 is a schematic configuration diagram showing a hardware configuration of the information providing system 10 in the present embodiment.
  • the information providing system 10 includes an agreeer information processing server 800 and a medical related service information processing server 900.
  • the consenter information processing server 800 includes a CPU 800a, a memory 800b, an HDD (Hard Disk Drive) 800c, and a NIC (Network Interface Card) 800d.
  • the consenter information processing server 800 includes an consenter information DB (Database) 800e, a master DB 800f, and a conversion DB 800g.
  • the consenter information DB corresponds to an example of the consenter information storage unit.
  • the consenter information processing server 800 corresponds to an example of the consenter information extraction unit, the format conversion unit, and the master conversion unit.
  • the medical related service information processing server 900 corresponds to an example of an agreeer information specifying unit, a non-consent item deleting unit, and a medical information deleting unit.
  • the information providing system 10 corresponds to an example of a medical information transmission unit.
  • the medical related service information processing server 900 includes a CPU 900a, a memory 900b, an HDD 900c, and a NIC 900d. Furthermore, the medical related service information processing server 900 includes a clinical test center A clinical test result information DB 900e, a clinical test center B clinical test result information DB 900f, and a clinical test center C clinical test result information DB 900g.
  • the clinical test result information DB 900e for the clinical test center A, the clinical test result information DB 900f for the clinical test center B, and the clinical test result information DB 900g for the clinical test center C correspond to an example of a medical information storage unit.
  • the CPU 800a develops various application software stored in the HDD 800c in the memory 800b, and uses the various information stored in the consenter information DB 800e, the master DB 800f, and the conversion DB 800g, Various processes such as updating and format conversion of consenter information are executed.
  • the consenter information processing server 800 communicates with the medical related service information processing server 900, the clinical laboratory centers A500, B600, and C700 and the network N by the NIC 800d.
  • the CPU 900a develops various application software stored in the HDD 900c in the memory 900b, the clinical laboratory result information DB 900e for the clinical laboratory center A, and the clinical laboratory result information DB 900f for the clinical laboratory center B.
  • various information stored in the clinical test result information DB 900g for the clinical test center C various processes such as extraction and transmission of a medical facility code such as a hospital, and deletion of non-consent information are executed. Details of the various processes will be described later.
  • a doctor obtains in advance an agreement from an individual patient about sharing personal information and medical information with other medical facilities for regional medical cooperation.
  • the doctor also obtains consent from each patient about the use of the information providing system 10.
  • the hospital A100 and the hospital B200 separate the consenter's personal information from the medical information so that the personal information and the medical information are not linked.
  • the hospital A100 and the hospital B200 participate in regional medical cooperation and have access authority to the regional medical cooperation server 300.
  • the hospital A100 and the hospital B200 send the separated personal information and the consenter information including the items agreed by the consenter from the respective servers in the hospital A100 and the hospital B200 via the network N. It transmits to the cooperation server 300.
  • the regional medical cooperation server 300 stores consenter information of patients who have agreed to regional medical cooperation in the regional medical area to which the hospital A100 and the hospital B200 belong.
  • FIG. 3 shows the contents of personal information and consenter information stored in the regional medical cooperation servers 300 and 400 in a table format. As shown in FIG. 3, these pieces of information are classified into basic patient information, documents, treatment / medicine history, disease names, sample test results, image test results, progress tables, and regional cooperation paths.
  • the patient basic information is information for specifying an individual patient.
  • the document is detailed information of medical services that the patient has received in the past.
  • the treatment / medication history is information on a prescription drug, a doctor in charge, etc. received by the patient in the medical service.
  • the disease name is information on the patient's disease.
  • the sample test result is information regarding the sample test received by the patient.
  • the image inspection result is information regarding an image created when the patient has undergone MRI (Magnetic Resonance Imaging), endoscopy, or the like, a doctor's findings, and the like.
  • the progress table is progress information such as surgery performed by the patient.
  • the regional alliance path is a so-called regional alliance critical path. From the "acute period" when the patient develops to the "recovery period” during which intensive rehabilitation is performed, until the "maintenance period” during which rehabilitation is performed to maintain living functions. It is information on a medical treatment plan table for receiving uninterrupted treatment. Further, primary information and secondary information as detailed information of each classification are stored below these classifications. Description of these detailed information is omitted.
  • the consenter information of the patient who has agreed to the disclosure and sharing is accumulated.
  • the consenter information processing server 800 of the information providing system 10 periodically connects to the regional medical cooperation servers 300 and 400, and is newly added from the consenter information stored in the regional medical cooperation servers 300 and 400.
  • the consenter information is acquired, and the consenter information stored in the consenter information DB 800e of the consenter information processing server 800 is updated.
  • the consenter information processing server 800 specifies the consenter information newly added to the regional medical cooperation servers 300 and 400 by using a known technique such as obtaining a difference of the consenter information data.
  • the regional medical cooperation servers 300 and 400 may transmit the consenter information to the consenter information processing server 800 periodically.
  • FIG. 4 shows an example of items of the consenter information stored in the consenter information DB 800e in addition to the consenter information shown in FIG. 3 in the present embodiment. Therefore, the consenter information DB 800e includes a wide area ID, a regional medical cooperation server code, a regional medical cooperation ID, a medical facility code, a medical facility patient ID, and consent clinical examination items. Each consenter information is associated with each other as a set of a wide area ID, a regional medical cooperation server code, a regional medical cooperation ID, a medical facility code, a medical facility patient ID, and consent clinical examination items.
  • the wide area ID is identification information that can identify individual patients within each prefecture or within the regional medical area.
  • An example of the wide area ID is an insurer number.
  • the regional medical cooperation server code is identification information assigned to the regional medical cooperation server.
  • the regional medical cooperation ID is unique identification information that the regional medical cooperation servers 300 and 400 allocate so that individual patients can be identified.
  • the medical facility code is unique identification information assigned to each medical facility, in this embodiment, the hospital A100 and the hospital B200.
  • the medical facility patient ID is identification information that the hospital A100 and the hospital B200 each independently allocate so as to be able to identify a patient who receives a medical service.
  • the consent clinical test item is information indicating details of the consenter information of the patient. In this embodiment, among the consenter information shown in FIG. 3, information that the patient has agreed to is registered as the consent clinical test item, and information that the patient does not agree is excluded from the consent clinical test item.
  • the hospitals A100 and B200 which are medical facilities participating in the regional medical cooperation, are connected to the clinical laboratory centers A500, B600, and C700 that are medical-related service providers in the regional medical area to which the hospitals A100 and B200 belong. Entrust clinical testing. Then, the hospital A100 and the hospital B200 receive reports on the results of clinical tests performed by the clinical laboratory centers A500, B600, and C700.
  • the hospital A100 and the hospital B200 each assign an identification number or the like that can identify an individual patient to a patient who receives medical services. Therefore, the hospital A100 and the hospital B200 also transmit the patient identification number and the like to the clinical laboratory centers A500, B600, and C700 to which clinical examinations are entrusted.
  • the clinical laboratory centers A500, B600, and C700 transmit clinical laboratory results to the medical related service information processing server 900 in the information providing system 10.
  • the clinical laboratory centers A500, B600, and C700 do not have consenter information regarding the patient to be clinically tested. Therefore, the clinical laboratory centers A500, B600, and C700 uniformly transmit all clinical laboratory results.
  • the medical related service information processing server 900 includes a clinical laboratory result information DB 900e for the clinical laboratory center A, a clinical laboratory result information DB 900f for the clinical laboratory center B, and a clinical laboratory result information DB 900g for the clinical laboratory center C.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A, the clinical laboratory result information DB 900f for the clinical laboratory center B, and the clinical laboratory result information DB 900g for the clinical laboratory center C are the clinical laboratory results assigned to the clinical laboratory centers A500, B600, and C700, respectively. It is a database for storing.
  • the clinical laboratory centers A500, B600, and C700 transmit all clinical laboratory results to the medical related service information processing server 900 installed in the information providing system 10.
  • each clinical laboratory center transmits the medical related service information processing server.
  • clinical laboratory results are sent to the clinical laboratory result information DB 900e for clinical laboratory center A, clinical laboratory result information DB 900f for clinical laboratory center B, and clinical laboratory result information DB 900g for clinical laboratory center C assigned to each clinical laboratory center.
  • each clinical laboratory center cannot obtain and view the clinical laboratory results of other clinical laboratory centers, and security for each clinical laboratory center is guaranteed. Therefore, the information providing system 10 can avoid the risk of information leakage and contamination of clinical test results.
  • FIG. 5 shows an example of items of clinical test results stored in the clinical test result DB 900e for the clinical test center A in this embodiment.
  • the clinical test result includes a medical facility code, a medical facility patient ID, and a clinical test content.
  • Each clinical test result is associated with a medical facility code, a medical facility patient ID, and a clinical test content as a set.
  • the medical facility code and the medical facility patient ID are the same as the information shown in FIG.
  • the contents of the clinical test are information on detailed information such as clinical tests commissioned by the clinical test center A500 from the hospital A100 and the hospital B200, clinical test results, and the like. Since the items of the clinical test results stored in the clinical test result DB 900f for the clinical test center B and the clinical test result information DB 900g for the clinical test center C are the same, the description thereof is omitted.
  • FIG. 6 shows a flowchart of the process of consenter information in the information providing system 10.
  • each step of the flowchart is abbreviated as S.
  • the flowchart illustrated in FIG. 6 is started.
  • the hospital A100 entrusts a clinical test to the clinical laboratory center A500, and after the clinical laboratory center A500 completes the clinical test, the clinical laboratory center A500 performs login processing to the medical-related service information processing server 900. The case where it went is demonstrated. The same applies to the description of the flowchart below.
  • clinical test result data from the clinical test center A500 is uploaded to the clinical test center A clinical test result information DB 900e.
  • the clinical test result data also includes medical facility code data received from the hospital A100 by the clinical test center A500. That is, in this embodiment, the medical facility code is identification information indicating the hospital A100.
  • the process proceeds to S102.
  • the medical facility code is extracted from the clinical test result uploaded to the clinical test center A clinical test result information DB 900e.
  • the process proceeds to S103.
  • the medical facility code is transmitted to the consenter information processing server 800 for inquiry processing to the consenter information DB 800e based on the medical facility code extracted from the clinical laboratory result information DB 900e for the clinical laboratory center A.
  • the consenter information processing server 800 refers to the received medical facility code with the consenter information stored in the consenter information DB. Thereby, the consenter information processing server 800 confirms whether or not the medical facility patient ID linked to the medical facility code exists.
  • the consenter information processing server 800 in S105, the regional medical cooperation server code and the regional medical cooperation ID associated with the medical facility patient ID.
  • the medical facility code, the medical facility patient ID, and the consent clinical test items are extracted and transmitted to the clinical test result information DB for each clinical test center.
  • the consenter information processing server 800 indicates that there is no corresponding consenter in the consenter information DB 800e in S106. 900 is notified.
  • the process of S105 or S106 is completed, the process of the flowchart shown in FIG. 6 ends.
  • description is abbreviate
  • the clinical laboratory result information DB 900e for the clinical laboratory center A receives the consenter out of the clinical laboratory results received from the clinical laboratory center A500 based on the consenter information received from the consenter information processing server 800 by the above processing.
  • the clinical test results of the corresponding patient and the clinical test results of the patient corresponding to the non-consent are selected.
  • FIG. 7 shows a flowchart regarding the selection process of the consenter and the non-agreeant in the clinical laboratory result information DB 900e for the clinical laboratory center A.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A has received the extraction result of the above consenter information from the consenter information processing server 800, that is, has acquired data in S105, This flowchart is started when a notification that it does not exist is received.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A uses the medical facility code transmitted to the consenter information processing server 800 in S103 for the consenter information received from the consenter information processing server 800. It is determined whether or not the associated medical facility patient ID exists.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A advances the process to S202.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A is a clinical facility having the medical facility patient ID determined to exist in S201 among the clinical laboratory results stored in the clinical laboratory result information DB 900e for the clinical laboratory center A.
  • the test result is determined to be a clinical test result corresponding to the consenter, and the clinical test result is held.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A holds information corresponding to the consent clinical laboratory items received from the consenter information processing server 800 in S105 among the clinical laboratory results corresponding to the consenter. Then, the clinical laboratory result information DB 900e for the clinical laboratory center A deletes information that does not correspond to the consent clinical laboratory items from the clinical laboratory results.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A is a medical facility other than the medical facility patient ID determined to exist in S201 among the clinical laboratory results stored in the clinical laboratory result information DB 900e for the clinical laboratory center A.
  • the clinical test result having the patient ID is determined to be a clinical test result corresponding to the non-consent, and the clinical test result is deleted.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A ends this flowchart.
  • the clinical laboratory result information DB 900e for the clinical laboratory center A also ends this flowchart when the process of S202 is completed.
  • the medical-related service information processing server 900 performs the process of FIG. 7, and the clinical test result of the clinical test performed by the clinical test center A500 based on the commission by the hospital A100, That is, the clinical test result of the non-consent can be selected. Then, the medical related service information processing server 900 transmits the clinical test result of the consenter selected by the above processing to the regional medical cooperation server 300. Thereby, the regional medical cooperation server 300 can share the clinical test result of the consenter between the hospital A100 and the hospital B200.
  • the stored clinical test results may be converted into a master or format as described below, as necessary. Only the master or the format may be converted, or the master and the format may be converted.
  • the clinical test result of the consenter stored in the regional medical cooperation server 300 by the above processing can be shared with another regional medical cooperation server 400.
  • medical facilities and medical-related service providing facilities manage various information according to so-called masters that systematize codes related to medical terms, medicines, disease names, and the like.
  • masters that systematize codes related to medical terms, medicines, disease names, and the like.
  • the regional medical cooperation servers 300 and 400 employ different masters.
  • the formats used when the regional medical cooperation servers 300 and 400 provide information data to medical facilities, medical related service providing facilities, and the like, that is, the formats of electronic medical records, are also different.
  • the information providing system 10 can share clinical test results even when the masters and formats adopted by the regional medical cooperation servers 300 and 400 are different.
  • the conversion DB 800g of the consenter information processing server 800 stores various formats employed by medical facilities, medical-related service providing facilities, and the like that the information providing system 10 provides various information.
  • the conversion DB 800g manages each medical facility, each medical-related service providing facility, and the like in association with the adopted format.
  • the master DB 800f of the consenter information processing server 800 stores various masters adopted by medical facilities, medical-related service providing facilities, and the like that the information providing system 10 provides various information.
  • the master DB 800f manages each medical facility, each medical-related service providing facility, and the like associated with the adopted master.
  • FIG. 8 shows a flowchart when the information providing system 10 performs settings related to conversion of data of clinical test results in the present embodiment.
  • the conversion of medical information including clinical test results is a master conversion of the format of the master code and the report format, and a plurality of formats are used for each medical facility and medical-related service providing facility. Conversion to a format in which data can be shared at a facility in the country is called format conversion.
  • the medical-related service information processing server 900 inquires of the conversion DB 800g about the clinical test result sending destination, here, the method of editing the clinical test result data including the format adopted by the regional medical cooperation server 400.
  • the conversion DB 800g receives an inquiry about a data editing method from the medical related service information processing server 900, the conversion DB 800g confirms the format adopted in the regional medical cooperation server 400.
  • the conversion DB 800g confirms that the format exists, that is, it can cope with the editing method for the data requested by the regional medical cooperation server 400 (S302: Yes), information such as the confirmed format Is transmitted to the medical-related service information processing server 900.
  • the medical-related service information processing server 900 sets a data editing method based on information such as the format received from the conversion DB 800g.
  • the medical-related service information processing server 900 has information on the association between the master to which the clinical test result is compliant and the delivery destination of the clinical test result, here, the master adopted by the regional medical cooperation server 400. Queries the master DB 800f. That is, by confirming the association information, the medical related service information processing server 900 can convert the master adopted by the clinical test result transmission source into the master adopted by the clinical test result transmission destination.
  • the master DB 800f when the master DB 800f receives an inquiry about the master linking information from the medical related service information processing server 900, the master DB 800f adopts the master adopted by the source of the clinical test result to be converted and the destination of the clinical test result. Check if there is any linking information with the master.
  • the master DB 800f When the master DB 800f confirms that the master's association information exists (S402: Yes), the master DB 800f transmits the confirmed master's association information to the medical-related service information processing server 900. In step S ⁇ b> 403, the medical related service information processing server 900 sets the master association information received from the master DB 800 f to be used for conversion of clinical test results.
  • FIGS. 8 and 9 may be executed first or in parallel.
  • the information providing system 10 starts the process of the flowchart shown in FIG.
  • master conversion and format conversion may be executed by the consenter information processing server 800 or may be executed by the server 900.
  • the master DB 800f or the conversion DB 800g in the consenter information processing server 800 is inquired about an editing method, and as a result, the medical information is processed according to the method notified to the medical related service information processing server 900. Conversion is executed in the related service information processing server 900.
  • FIG. 10 is a flowchart illustrating an example of a case in which the medical-related service information processing server 900 of the information providing system 10 performs the master conversion after the format conversion in the clinical test result conversion processing in the present embodiment.
  • the medical related service information processing server 900 validates the data editing method such as the format set by the processing of the flowchart shown in FIG. Next, the process proceeds to S502.
  • the medical related service information processing server 900 validates the master linking information set by the processing of the flowchart shown in FIG. Next, the process proceeds to S503.
  • the medical related service information processing server 900 converts the clinical test result in accordance with the validated format or the master information.
  • the medical related service information processing server 900 obtains the converted clinical test result.
  • the clinical test result after conversion becomes a clinical test result based on the format or the master adopted by the regional medical cooperation server 400 here. Therefore, the regional medical cooperation server 400 can provide the hospital A100 and the hospital B200 also with the clinical test results with different formats and masters by the information providing system 10.
  • FIG. 11 shows a flowchart when the information providing system 10 transmits the clinical test result converted to the regional medical cooperation servers 300 and 400 in the present embodiment.
  • the case where the clinical test result converted for the regional medical cooperation server 400 as described above is transmitted to the regional medical cooperation server 400 will be described.
  • the medical-related service information processing server 900 when the medical-related service information processing server 900 generates converted clinical test result data by the process of the flowchart shown in FIG. 10, the information providing system 10 starts the process of the flowchart shown in FIG. .
  • the medical related service information processing server 900 transmits the data of the clinical test result after conversion to the consenter information processing server 800.
  • the consenter information processing server 800 receives the converted data.
  • the consenter information processing server 800 advances the processing to S603.
  • the consenter information processing server 800 transmits the conversion data received in S602 to the regional medical cooperation server 400.
  • the regional medical cooperation server 400 receives the conversion data.
  • the provision of medical services and medical-related services is one facility-complete type that completes all medical services and medical-related services within a single medical facility, such as the current one. It is conceivable that the number of distributed types will increase as medical facilities and a plurality of medical-related service facilities will be shared. Therefore, the number of cases where a single patient uses multiple medical facilities will increase further in the future, and the importance of managing personal information will increase further.
  • each medical facility is primarily responsible for obtaining consent individually, but the type of consent acquired also depends on the medical care to which the medical facility belongs. Consent to participate in regional medical cooperation in the area, consent to data sharing at multiple medical facilities, consent to secondary use of data in a form that separates personal information (cohort studies, etc.).
  • the consent content is not uniform, such as the fact that each item of medical record information, medication history, and clinical test results included in medical information may be agreed to share only specific items. It is possible that not only will increase, but the contents will become more complex in the future.
  • Physician associations, medical facilities, and healthcare-related service providers that control the medical sphere have restrictions on the information they can own and manage.
  • the medical facility can only grasp information about the patient at its own facility, and the medical association overseeing the medical sphere has only information about who is the consenter.
  • medical-related service providers for example, clinical laboratories cannot grasp the results of clinical tests at other facilities, and for clinical tests that have been commissioned, patient identification information such as patient names and clinical Although we know the test results, we cannot know which patients are the patients who have agreed to share medical information.
  • the above embodiment makes it easy to share data transmitted by a plurality of medical-related service providing facilities with a plurality of medical facilities. If it becomes easy for medical facilities and medical related service providing facilities to participate in such an integrated system, it becomes easier to construct a system in which more medical facilities and medical related service providing facilities cooperate.
  • the patient information integrated across the medical facilities can be referred to by the patient individually, which leads to improvement of patient convenience.
  • medical facilities and medical service providers can share high-efficiency medical information to support a high level of expertise that can cope with the advancement and complexity of medical care due to advances in medical technology and equipment. . As a result, it becomes possible to enjoy high-quality medical services efficiently.
  • the regional medical cooperation server is configured to accumulate patient information transmitted from a medical facility such as a hospital.
  • the information processing system receives patient information and receives a DB or the like. It is good also as a structure accumulate
  • a server for cohort research can be provided, and by the above configuration and processing, consenter information can also be shared in cohort research.
  • the medical information to be shared is not limited to this.
  • the medical information may include any of medical record information, receipt information, medical information, medical information, prevention information, health information, and welfare information.
  • the medical information is medical chart information
  • the medical information may include a clinical test result, a doctor's findings, a progress or result of treatment, a nursing record, a prescription, or a visit history.
  • a medical-related service falls under any of those listed in the Medical Law Enforcement Regulations, such as contracted clinical testing, dispensing pharmacy services, medical device sales / maintenance inspection, etc., it is transmitted from the medical-related service providing facility Information may be shared.
  • the structure of said embodiment can be made to respond
  • a system that can predict future diseases by designing an algorithm that combines medical record information, medical information, medical information, prevention information, health information, clinical test results, doctor's findings, progress and results of treatment, etc. Can also be built.
  • a case is assumed in which medical information is shared across medical areas when the patient uses medical facilities in different medical areas.
  • medical information and a medical-related service can be efficiently provided by sharing medical information among a plurality of medical facilities in different medical areas.
  • different regional medical spheres that is, operated by a medical association, etc.
  • the regional medical cooperation servers in the respective regional medical areas can share medical information via the information providing system of the above embodiment.
  • a server may be provided for wide area connection that can be connected to these regional medical cooperation servers, and this wide area cooperation server may relay each regional medical cooperation server and the information providing system.
  • the information providing system may be configured to perform this relay.
  • the regional medical cooperation servers 300 and 400 transmit medical information to the wide area cooperation server via the medical information to the information providing system 10 and share the medical information between the regional medical cooperation servers 300 and 400.
  • the clinical test result transmitted from the clinical laboratory center A500 to the information providing system 10 is shared by the regional medical cooperation server and further shared by the wide area medical cooperation server.
  • clinical test results are transmitted from the regional medical cooperation server to the test result information DB for the test center A.
  • the clinical test result also includes a regional medical cooperation server code, a regional medical cooperation ID, and a wide area ID.
  • FIG. 14 is a schematic configuration diagram showing a hardware configuration of the information providing system 10 in the present embodiment.
  • the medical related service information processing server 900 is a regional medical cooperation server that can be accessed by the regional medical cooperation server 300 clinical test result information DB 900 h accessible by the regional medical cooperation server 300 and the regional medical cooperation server 400. 400 clinical test result information DB 900i is provided.
  • the regional medical cooperation server code is transmitted to the consenter information processing server 800 for inquiry processing to the consenter information DB 800e based on the regional medical cooperation server code extracted from the clinical test result information DB 900h for the regional medical cooperation server 300. Is done.
  • the consenter information processing server 800 inquires the received regional medical cooperation server code with the consenter information stored in the consenter information DB. Thereby, the consenter information processing server 800 confirms whether or not the wide area ID associated with the regional medical cooperation server code exists.
  • the consenter information processing server 800 in S705, the regional medical cooperation server code, the regional medical cooperation ID, and the medical facility code associated with the wide area ID.
  • the medical facility patient ID and consent clinical examination items are extracted and transmitted to the clinical examination result information DB for each regional medical cooperation server.
  • the consenter information processing server 800 indicates that the corresponding wide-area ID does not exist in the consenter information DB 800e in S706. Notify the result information DB 900h.
  • FIG. 13 shows a flowchart regarding the selection process of the consenter and the non-agreeant in the clinical test result information DB 900h for the regional medical cooperation server 300.
  • the clinical examination result information DB 900h for the regional medical cooperation server 300 has received the extraction result of the above-mentioned consenter information from the consenter information processing server 800, that is, acquired data in S705 or a wide area ID in S706. This flowchart is started when a notification to the effect that no exists is received.
  • the clinical examination result information DB 900h for the regional medical cooperation server 300 transmits the local medical cooperation transmitted from the consenter information processing server 800 to the consenter information processing server 800 in step S703. It is determined whether or not a wide area ID associated with the server code exists.
  • the clinical test result information DB 900h for the regional medical cooperation server 300 advances the process to S802.
  • the clinical test result information DB 900h for the regional medical cooperation server 300 is the clinical ID having the wide area ID determined to exist in S801 among the clinical test results stored in the clinical test result information DB 900h for the regional medical cooperation server 300.
  • the test result is determined to be a clinical test result corresponding to the consenter, and the clinical test result is held.
  • the clinical test result information DB 900h for the regional medical cooperation server 300 holds information corresponding to the consent clinical test item received from the consenter information processing server 800 in S705 among the clinical test results corresponding to the consenter. Then, the clinical test result information DB 900h for the regional medical cooperation server 300 deletes information that does not correspond to the agreed clinical test items from the clinical test results.
  • the clinical examination result information DB 900h for the regional medical cooperation server 300 is a wide area ID other than the wide area ID determined to exist in S801 among the clinical examination results stored in the clinical examination result information DB 900h for the regional medical cooperation server 300. Is determined to be a clinical test result corresponding to a non-consent, and the clinical test result is deleted.
  • the clinical test result information DB 900h for the regional medical cooperation server 300 ends this flowchart.
  • the clinical test result information DB 900h for the regional medical cooperation server 300 also ends this flowchart when the process of S802 is completed.
  • the configuration and processing of the present embodiment are the same as in FIG. 1 except that the above-mentioned regional medical cooperation server 300 belongs to a medical area and the regional medical cooperation server 400 belongs to another medical area. Since the specific configuration and processing of the embodiment shown in FIG. 11 are the same, detailed description thereof is omitted.
  • telemedicine refers to an act of performing medical care using a communication technology such as the Internet at a distance between a doctor and a patient.
  • a communication technology such as the Internet
  • the present invention can be used mainly in telediagnosis.
  • telemedicine can be effective not only for sparsely populated areas but also for patients who are difficult to visit hospitals, such as doctors can diagnose patients before they become serious. It is done.
  • it can be used for sharing medical information in the same medical facility, for example, in one hospital.
  • medical information can be shared using the configuration of the above embodiment.
  • the results output by different clinical laboratory instruments are integrated and shared, for example, in a medical facility such as a large hospital, an X-ray diagnostic apparatus, an X-ray CT apparatus, a magnetic resonance imaging apparatus, a nuclear medicine apparatus, an ultrasonic diagnostic apparatus, etc. It can be used when there are a plurality of clinical laboratory instruments that output clinical laboratory results in various formats.
  • the above regional medical cooperation servers 300 and 400 are considered as cooperation servers belonging to one hospital, and the hospital A100 and hospital B200 are considered as respective clinical departments in the hospital, and the information providing system 10
  • the network N is the same as the specific configuration and processing of the above-described embodiment except that the network N is arranged in the hospital, and detailed description thereof is omitted.
  • regional medical cooperation refers to sharing medical information associated with medical services and medical-related services provided for patients using a plurality of different medical facilities.
  • the Ministry of Health, Labor and Welfare Includes the provision of medical services and medical-related services by linking medical facilities in the primary to tertiary medical areas and medical-related service providing facilities.
  • they may be referred to as wide-area medical collaborations.
  • target consenter information not only specific regional medical cooperation such as wide area medical cooperation and regional medical cooperation in Japan but also medical information in a wide range using insurer database, national database and global database. Sharing is also possible.
  • the content of the consenter's consent varies depending on the type of consent to be obtained. For example, consent to participate in regional medical cooperation in the medical area to which the medical facility providing the service belongs, consent to share medical information in multiple medical facilities, secondary medical information in a form where personal information is separated Consent to use (such as cohort studies) is included.
  • the contents of the consent of the consenter can further include information on organ donation, living will refusal of life extension, dignity death, and the like.
  • the consenter information includes a number assigned to each medical facility, a number assigned to each patient by each medical facility, and from the primary to which the medical facility belongs as necessary.
  • a tertiary medical zone number can be added.
  • the medical facility information is associated with the number assigned to each medical facility
  • the patient identification information is associated with the number assigned to the patient by each medical facility.
  • the wide area ID is an insurer number as an example, but a number assigned to each area, for example, a prefectural number, a country code, a national number, an international number, or a combination thereof is used. There are also things.
  • the consenter information DB is installed and operated separately from the medical information DB.
  • the consenter information DB may be installed in the same server as the medical information DB or may be installed in another server.
  • the consenter information DB is preferably installed in another server of the medical information DB. This is particularly effective when medical information is shared across multiple regions as described above.
  • the medical service in the above description may include an act of performing diagnosis or treatment using a biological sample in the biobank or information related thereto.
  • medical-related services include biobanks and biobank information system operations.
  • the biobank refers to a biological sample derived from a provider belonging to a certain group or a part of the group or information related thereto
  • the biobank information system refers to the biological sample of the biobank or information related thereto. Refers to the accumulation of information stored in a systematized system.
  • a medical-related service providing facility a facility that manages and operates a biobank information system can be cited.
  • information related to biological samples which is handled in the biobank and the biobank information system, in medical information shared among a plurality of medical facilities.
  • Information related to biological samples includes, for example, genome and its mutation information, protein, sugar chain, information obtained by metabolomic analysis, bioimaging information, information on separated microorganisms, and a combination of these information.
  • the individuals in the personal information handled in the biobank and the biobank information system include medical information providers and patients who receive diagnosis and treatment by doctors.
  • the present invention is particularly effective when applied to a case where there are a plurality of medical-related service providing facilities that provide operation of the biobank and the biobank information system.
  • the biological samples and medical information are derived from the same medical information provider, the medical information held in the respective medical related service providing facilities may not be unified and may not completely match.
  • the above problems may occur.
  • the method of the present invention such a problem may occur. The problem can also be solved.
  • an area in regional medical cooperation refers to an area (for example, a medical area or the like) that forms a group or organization under a certain agreement and includes a plurality of medical facilities and medical related service providing facilities ).
  • the set area is a municipality unit, a prefecture unit, a country unit, an organization formed for a specific purpose or a study group unit, etc.
  • size, the range, etc. are not limited, What is necessary is just to include several medical facilities and medical related service provision facilities.
  • An information storage device having a medical information storage unit can be installed for each unit for which provision of medical information is desired, and the medical information in this embodiment is controlled by installing the information storage device for each unit. It becomes possible to share.
  • the above-described embodiment can be realized for a medical information provider in place of or in addition to the patient. Therefore, individuals including at least a patient or a medical information provider can appropriately select the usage of the medical information to be shared according to the form of providing the medical service or the medical related service.

Abstract

Dans la présente invention, un système de traitement d'informations est configuré pour comporter : une unité de stockage d'informations de personne consentante pour stocker des informations de personne consentante extraites à partir d'un dispositif de stockage d'informations accessible par un terminal d'une installation médicale, informations dans lesquelles des informations d'installation médicale et des informations d'identification de patient sont reliées ; une unité de stockage d'informations médicales accessible par un terminal d'une installation de fourniture de service médical ayant demandé un service médical auprès de l'installation médicale, et utilisée pour stocker des informations médicales dans lesquelles les informations d'installation médicale, les informations d'identification de patient et des informations concernant le service médical demandé sont reliées ; une unité d'extraction d'informations de personne consentante pour extraire, à partir des informations de personne consentante stockées dans l'unité de stockage d'informations de personne consentante, des informations de personne consentante ayant les informations d'installation médicale stockées dans l'unité de stockage d'informations médicales ; une unité de spécification d'informations de personne consentante pour spécifier, parmi les informations médicales, des informations médicales ayant les informations d'identification de patient des informations de personne consentante extraites ; et une unité de transmission d'informations médicales pour transmettre les informations médicales spécifiées au dispositif de stockage d'informations.
PCT/JP2014/059581 2013-03-29 2014-03-31 Système de fourniture d'informations et procédé de commande de système de fourniture d'informations WO2014157729A1 (fr)

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